Rotator Cuff Injuries and Tears
Table of Contents
What is the rotator cuff
The rotator cuff is a complex of four muscles and tendons that stabilize the shoulder joint. It consists of the supraspinatus, infraspinatus, teres minor, and subscapularis, which press the humeral head firmly against the glenoid of the scapula and enable stable shoulder motion. Among them, the supraspinatus tendon is the most vulnerable and is most commonly injured.
Types of injury
- Tendinitis: The earliest stage, with microtrauma and inflammation of the tendon. Pain occurs when raising the arm, but strength is preserved.
- Partial tear: Some fibers of the tendon are torn, causing pain along with mild loss of strength.
- Full-thickness tear: The tendon is completely torn. Conservative treatment is possible if the tear is small, but large tears may require surgical repair.
- Degenerative vs. traumatic: After age 40, gradual degenerative damage is common; acute tears can also occur from falls or lifting heavy objects.
Korean medicine treatment
Up to a partial tear, sufficient functional recovery is possible with conservative Korean medicine treatment, and Korean medicine is also effective in postoperative rehabilitation.
- Pharmacopuncture: Bee venom (BV) pharmacopuncture and Jahageo (紫河車, placenta) pharmacopuncture are administered directly into the injured area to simultaneously promote anti-inflammation and tissue regeneration. The melittin component of bee venom exerts a strong anti-inflammatory effect.
- Acupuncture: Shoulder points such as Jianyu (LI15), Jianliao (TE14), and Jugu (LI16) are combined with the source points (原穴) of the upper-limb meridians.
- Herbal medicine: Sipjeondaebo-tang (十全大補湯), which tonifies qi and nourishes blood, is supplemented with bone- and tendon-strengthening herbs such as Sokdan (續斷, Dipsacus) and Golsaebo (骨碎補, Drynaria) to promote tendon healing.
- Chuna manipulation: Realigns the shoulder joint and widens the subacromial space to reduce friction on the tendons.
Rehabilitation exercise program
In the early stage, passive joint motion is used to maintain flexibility; once pain decreases, internal- and external-rotation strengthening with resistance bands is started. Excessive overhead motions should be avoided, but complete rest can cause muscle atrophy and adhesions, so active rehabilitation within a pain-free range is essential.